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Cunha GHD, Ramalho AKL, Fontenele MSM, Dantas MB, Fechine FV, Abreu WCD. Quality of life and adherence to antiretroviral therapy in people living with HIV in the Ceará, Brazil. AIDS Care 2024; 36:400-413. [PMID: 37909100 DOI: 10.1080/09540121.2023.2275035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
The aim of this study was to investigate the quality of life (QOL) and adherence to antiretroviral therapy (ART) in people living with HIV (PLWH) in Fortaleza, Ceará, Brazil. A cross-sectional study with a sample of 385 patients followed-up on an outpatient basis. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form, the World Health Organization's Quality of Life in PLWH Instrument, the Assessment of Adherence to Antiretroviral Treatment Questionnaire and Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed. The odds ratio and confidence interval were calculated, considering P < 0.05 as statistically significant. Of the 385 PLWH, 134 (34.8%) had unsatisfactory QOL which was associated with unemployment (P = 0.0037), monthly income less than the minimum wage (P < 0.0001), sleep disorders (P = 0.0039) and not doing regular exercise (P = 0.0032). Inadequate adherence to ART occurred in 24 patients (6.23%) and was associated with detectable viral load (P = 0.0001) and unsatisfactory QOL (P = 0.0033). QOL was more unsatisfactory for those unemployed and with low income, sleep disorders and sedentary lifestyle. People with detectable viral load and unsatisfactory QOL had more inadequate adherence to ART.
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Silva GJD, Mendicino CCP, Pádua CAMD, Tupinambás U. Suppression of HIV in the first 12 months of antiretroviral therapy: a comparative analysis of dolutegravir- and efavirenz-based regimens. EINSTEIN-SAO PAULO 2023; 21:eAO0156. [PMID: 37255057 DOI: 10.31744/einstein_journal/2023ao0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/16/2022] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE To compare viral suppression in treatment-naïve adults starting antiretroviral therapy with dolutegravir (50mg)- and efavirenz (600mg)-based regimens. METHODS We analyzed secondary data from Brazilian health information systems of people living with human immunodeficiency virus who started antiretroviral therapy between 2015 and 2017 in Minas Gerais, Brazil. The outcome was viral suppression, defined as the achievement of the first viral load <50 copies/mL within 12 months after initiating antiretroviral therapy. This outcome was also compared with viral load <1,000 copies/mL and analyzed in two scenarios: intention-to-treat versus per-protocol. Time to viral suppression and adjusted odds ratio accompanied by 95% confidence intervals were estimated. RESULTS Of the 2,599 participants enrolled, 77.5% were men, and the median age was 34 years. In the intention-to-treat analysis, viral suppression was 58.1% for efavirenz and 76.7% for dolutegravir. People living with HIV on dolutegravir-based regimen were more likely to achieve viral suppression (aOR: 2.44; 95%CI: 2.01-2.95) and had a shorter median time to viral suppression (p<0.0001). Antiretroviral therapy initiation within <120 days, baseline CD4⁺T-cells ≥200 cells/mm3, and viral load <100,000 copies/mL had higher odds of viral suppression. According to the per-protocol analysis, viral suppression ≥90% was observed by considering viral load <1,000 copies/mL. CONCLUSION Our study demonstrated that viral suppression improved after introducing dolutegravir, although the proportion of patients with viral load <50 copies/mL was lower than expected. Improved access to routine viral load examinations and continuous surveillance of the effectiveness of antiretroviral therapy should be considered.
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Affiliation(s)
| | | | | | - Unaí Tupinambás
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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HIV and Substance Use in Latin America: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127198. [PMID: 35742448 PMCID: PMC9222977 DOI: 10.3390/ijerph19127198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/08/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
This scoping review aims to explore the interplay between substance use (SU) and HIV in Latin America (LA). Database searches yielded 3481 references; 196 were included. HIV prevalence among people who used substances (PWUS) ranged from 2.8–15.2%. SU definitions were variable throughout studies, and thus data were not easily comparable. In 2019, only 2% of new HIV infections were attributed to injection drug use (IDU) in LA. Factors associated with HIV among PWUS included being female, IDU and homelessness, and PWUS were likely to engage in risky sexual behaviors, start antiretroviral treatment late, have poor adherence, have treatment failure, be lost to follow-up, have comorbidities, and experience higher mortality rates and lower quality of life, as has been reported in PLWH with SU in other regions. Five intervention studies were identified, and only one was effective at reducing HIV incidence in PWUS. Interventions in other regions have varying success depending on context-specific characteristics, highlighting the need to conduct more research in the LA region. Though progress has been made in establishing SU as a major concern in people living with HIV (PLWH), much more is yet to be done to reduce the burden of HIV and SU in LA.
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Mendes JC, Ceccato MDGB, Reis AMM, Costa AMGD, Pantuzza LLN, Furtado dos Santos S, Crepalde-Ribeiro K, Silveira MR. Active Pharmacovigilance Project on the safety profile of Dolutegravir in Brazil. AIDS Care 2022; 35:729-738. [PMID: 35578399 DOI: 10.1080/09540121.2022.2062289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A quantitative descriptive study based on Brazilian Active Pharmacovigilance of Dolutegravir (DTG) Project was performed to describe the adverse drug reactions (ADRs) to DTG reported and to evaluate the noncompleteness of data from DTG active pharmacovigilance in Brazil. ADRs and clinical and individual data were obtained from information from the Pharmacovigilance Questionnaire from April 2017 to August 2019. The reported ADRs were classified using the Medical Dictionary for Regulatory Activities (MedDRA). In the evaluated period, 249,066 individuals using DTG participated in the active pharmacovigilance of DTG, with 3472 (1.39%) reporting ADRs at least once. A total of 6312 ADRs were reported, of which 57.56% were persistent and 81.46% were not serious according to the individuals' reports. Most of the reported ADRs were gastrointestinal, neurological and psychiatric. ADRs related to neural tube defects and serious neuropsychiatric ADRs have been reported. Completion of more than half of the fields in the Pharmacovigilance Questionnaire was excellent. The frequency of ADR was low in relation to the number of people living with HIV (PLHIV) using DTG in Brazil, which suggests good tolerability and safety of DTG. The DTG active pharmacovigilance database in Brazil showed good data completeness.
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Affiliation(s)
- Jullye Campos Mendes
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria das Graças Braga Ceccato
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Farmácia Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Adriano Max Moreira Reis
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Produtos Farmacêuticos, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Lais Lessa Neiva Pantuzza
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Simone Furtado dos Santos
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kennedy Crepalde-Ribeiro
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Micheline Rosa Silveira
- Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Farmácia Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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de Oliveira França P, Ayres LR, Pimassoni LH, Cerutti Junior C. Health-Related Quality of Life and Coping Strategies in a Cohort Study of Highly Active Antiretroviral Therapy Naïve Patients Adherence. Int J Clin Pract 2022; 2022:8341638. [PMID: 35685558 PMCID: PMC9159168 DOI: 10.1155/2022/8341638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The main objective of this study was to describe the perceived quality of life (QoL) in patients living with AIDS (PLWA) and their chosen coping strategies in a cohort of individuals managed with HAART. METHODS This is a prospective cohort study conducted at the Medication Dispensing Unit of a university hospital (MDU-UH) located in southeastern Brazil. Study population comprised HIV/AIDS patients starting antiretroviral treatment at MDU. The final sample comprised 99 participants. Patients were followed up for 24 months from their recruitment. We used a face-to-face questionnaire to determine sociodemographic and behavioural variables. Quality of life (QoL) and coping strategies (CS) were measured through validated instruments. RESULTS Regarding the QoL dimensions, the general perception of QoL among these participants was considered good. Regarding CS, the adherent patients scored higher than the nonadherents. CONCLUSIONS The present study revealed that the perceived QoL can be maintained in individuals treated for HIV/AIDS. There is an association between high score of coping strategies and adherence to HAART.
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Affiliation(s)
- Patricia de Oliveira França
- Post-Graduate Program of Infectious Diseases, Federal University of Espirito Santo, Vitória, Espirito Santo, Brazil
| | - Lorena Rocha Ayres
- Department of Pharmaceutical Sciences, Federal University of Espirito Santo, Vitória, Espirito Santo, Brazil
| | - Lúcia Helena Pimassoni
- School of Medicine, Escola Superior de Ciências da Santa Casa de Misericórdia de Vitória, Vitoria, Espirito Santo, Brazil
| | - Crispim Cerutti Junior
- Post-Graduate Program of Infectious Diseases, Federal University of Espirito Santo, Vitória, Espirito Santo, Brazil
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Qian Z, Zhang Y, Xie X, Wang J. Efficacy and safety of traditional Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e28287. [PMID: 34967361 PMCID: PMC8718220 DOI: 10.1097/md.0000000000028287] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Acquired immunodeficiency syndrome (AIDS) is one of the infectious diseases pandemic in the word. Traditional Chinese herbal medicine, as an alternative and complementary therapy of highly active antiretroviral therapy (HAART), has been put into the treatment of human immunodeficiency virus (HIV)/AIDS over 30 years due to its good therapeutic effects and high safety, while there is a lack of evidence-based medicine support. The purpose of this study is to explore the efficacy and safety of traditional Chinese herbal medicine combined with HAART for HIV/AIDS patients. METHODS We will search all randomized controlled trials of Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS from electronic databases including PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, WanFang, China Science and Technology Journal Database and Chinese Biomedical Literature Database from inception to December 31, 2021. Literature screening will be conducted through EndNote software, and data extraction will be processed according to inclusion and exclusion criteria by two independent researchers. We will use Review Manager 5.4 and Stata 16 software for data analysis and publication bias test. RESULTS This systematic review and meta-analysis will provide a high-quality evidence for the efficacy and safety of traditional Chinese herbal medicine combined with HAART in the treatment of HIV/AIDS. CONCLUSION The conclusion of this review will provide an objective assessment to evaluate whether Chinese herbal medicine integrated with HAART has the effect of improving the efficiency and depressing the toxicity. REGISTRATION NUMBER INPLASY2021110082.
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Affiliation(s)
- Zhenzhen Qian
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Yujin Zhang
- The Second Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xiaoli Xie
- Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Junwen Wang
- Hunan University of Chinese Medicine, Changsha, Hunan, China
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Pimentel GS, Ceccato MDGB, Costa JDO, Mendes JC, Bonolo PDF, Silveira MR. Quality of life in individuals initiating antiretroviral therapy: a cohort study. Rev Saude Publica 2020; 54:146. [PMID: 33331489 PMCID: PMC7726918 DOI: 10.11606/s1518-8787.2020054001920] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 02/06/2020] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To assess longitudinally the change in quality of life in people living with HIV initiating antiretroviral therapy in three public reference services specialized in HIV care in Belo Horizonte, Brazil. METHODS Prospective cohort study among people living with HIV, aged 18 years or older, and initiating antiretroviral therapy. We obtained sociodemographic, behavioral, clinical data related to pharmacological treatment and to the service by face-to-face interviews, and supplemented these data with information from clinical records and Information Systems of the Brazilian HIV/AIDS Program. We measured the quality of life using the WHOQOL-HIV bref instrument, with a minimum interval of six months between the baseline and the follow-up interviews. We used paired t-test to assess the mean change in quality of life between the two interviewsand evaluated factors associated with this outcome using multiple linear regression. RESULTS The overall quality of life, as well as the physical, psychological, level of independence, environment and spiritual quality of life domains were statistically higher in people living with HIV using antiretroviral therapy at the end of the follow-up. Factors independently associated with the increase in quality of life were having religious belief and living with other people. Having signs or symptoms of anxiety and depression and the number of adverse drug reactions reported were predictors associated with worsening quality of life. CONCLUSIONS These results show an improvement in the quality of life over time in people living with HIV on antiretroviral therapy. They also highlight the need to monitor and provide health care support, especially for individuals with signs and symptoms of anxiety and depression and that report adverse reactions to medicines at the beginning of treatment.
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Affiliation(s)
- Gabriela Sales Pimentel
- Universidade Federal de Minas Gerais. Faculdade de Farmácia. Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica. Belo Horizonte, MG, Brasil
| | - Maria das Graças Braga Ceccato
- Universidade Federal de Minas Gerais. Faculdade de Farmácia. Departamento de Farmácia Social. Belo Horizonte, MG, Brasil
| | - Juliana de Oliveira Costa
- University of New South Wales. Centre for Big Data Research in Health. Faculty of Medicine. Sydney, Australia.,Universidade Federal de Minas Gerais. Faculdade de Medicina. Pós-Graduação em Saúde Pública. Belo Horizonte, MG, Brasil
| | - Jullye Campos Mendes
- Universidade Federal de Minas Gerais. Faculdade de Farmácia. Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica. Belo Horizonte, MG, Brasil
| | - Palmira de Fátima Bonolo
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brasil
| | - Micheline Rosa Silveira
- Universidade Federal de Minas Gerais. Faculdade de Farmácia. Departamento de Farmácia Social. Belo Horizonte, MG, Brasil
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Fernández-Bargiela N, Rotea-Salvo S, Margusino-Framiñán L, Balboa-Barreiro V, Martín-Herranz I, Castro-Iglesias Á, Mena-De-Cea Á, López-Calvo S, Vázquez-Rodríguez P, Míguez-Rey E, Cid-Silva P. Discontinuation due to neuropsychiatric adverse events with efavirenz- and dolutegravir-based antiretroviral therapy: a comparative real-life study. Eur J Hosp Pharm 2020; 29:207-211. [PMID: 33051194 DOI: 10.1136/ejhpharm-2020-002374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/19/2020] [Accepted: 08/18/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Despite the high efficacy of antiretroviral treatment, no drug is free from adverse events (AEs). Efavirenz (EFV) and dolutegravir (DTG) are antiretroviral drugs for which neuropsychiatric adverse events (NPAEs) have been described. This study evaluated the safety and tolerability of DTG-based and EFV-based antiretroviral regimens in HIV-infected patients. METHODS A retrospective observational study was carried out in HIV-infected patients who started DTG- or EFV-based antiretroviral treatment from January 2008 to December 2018 at a reference hospital in north-western Spain. Epidemiological, clinical and immunovirological data were recorded. A statistical analysis was performed with SPSS software. RESULTS A total of 282 DTG- and 148 EFV-based therapies were initiated. During follow-up, statistically significant differences have been found between the rate of patients who discontinued DTG and EFV due to AEs (12.1% vs 35.8%, p<0.001) and the main AEs in both groups, NPAEs (8.2% vs 25.0%, p<0.001). Female gender (OR 2.610 (95% CI 1.327 to 5.133), p=0.005) was associated with discontinuations due to AEs. Patients with documented psychiatric disorders were at higher risk of discontinuation due to NPAEs (OR 4.782 (95% CI 1.190 to 19.220), p=0.027). The multivariate analysis showed a 61.2% risk reduction in benzodiazepine prescriptions in patients treated with DTG. In both groups, patients needed consultation and follow-up in the psychiatry unit (16.9% in the EFV group and 8.9% in the DTG group, p=0.021). CONCLUSIONS We found a high rate of discontinuations due to AEs and NPAEs, prescription of benzodiazepines and a requirement for consultation in a psychiatric unit in both treatment groups, especially with EFV.
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Affiliation(s)
| | - Sandra Rotea-Salvo
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Luis Margusino-Framiñán
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain.,Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain
| | - Vanesa Balboa-Barreiro
- Clinical Epidemiology and Biostatistics Unit, Biomedical Research Institute of A Coruña (INIBIC), Universitary Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña (UDC), A Coruña, Spain
| | - Isabel Martín-Herranz
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Ángeles Castro-Iglesias
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain.,Service of Infectious Internal Medicine, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Álvaro Mena-De-Cea
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain.,Service of Infectious Internal Medicine, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Soledad López-Calvo
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain.,Service of Infectious Internal Medicine, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Pilar Vázquez-Rodríguez
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain.,Service of Infectious Internal Medicine, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Enrique Míguez-Rey
- Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain.,Service of Infectious Internal Medicine, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain
| | - Purificación Cid-Silva
- Service of Pharmacy, Universitary Hospital of A Coruña (CHUAC), SERGAS, A Coruña, Spain .,Division of Clinical Virology, Biomedical Research Institute of A Coruña (INIBIC), University Hospital of A Coruña (CHUAC), SERGAS, Universitary of A Coruña, A Coruña, Spain
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Dai L, Su B, Liu A, Zhang H, Wu H, Zhang T, Shao Y, Li J, Ye J, Bai S, Guo X, Sun L. Adverse events in Chinese human immunodeficiency virus (HIV) patients receiving first line antiretroviral therapy. BMC Infect Dis 2020; 20:158. [PMID: 32075584 PMCID: PMC7031902 DOI: 10.1186/s12879-020-4878-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 02/12/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Although the global human immunodeficiency virus (HIV) epidemic has improved significantly due to antiretroviral treatment (ART), ART-related adverse events (AEs) remain an issue. Therefore, investigating the factors associated with ART-related AEs may provide vital information for monitoring risks. METHODS A prospective cohort study was conducted among adult patients (aged 18 years or older) with HIV who received Tenofovir (TDF) + Lamivudine (3TC) + Efavirenz (EFV) as first-line ART regimens. All AEs during the first 12 months of therapy were recorded. Logistic regression analysis was used to identify variables associated with AEs. RESULTS Four hundred seventy-four patients receiving TDF+ 3TC+ EFV ART regimens between March 2017 and October 2017 were included in the study analysis. Among them, 472 (99.6%) experienced at least one AE, 436 (92.0%) patients experienced at least one AE within 1 month of treatment, 33 (7.0%) between one and 3 months of treatment, and three (0.6%) patients after 3 months of treatment. The most commonly reported AE was nervous system (95.6%) related, followed by dyslipidemia (79.3%), and impaired liver function (48.1%). Patients with baseline body mass index (BMI) greater than 24 kg/m2 (adjusted OR 1.77, 95%CI 1.03-3.02), pre-existing multiple AEs (adjusted OR 2.72, 95%CI 1.59-4.64), and pre-existing severe AEs (adjusted OR 5.58, 95%CI 2.65-11.73) were at increased odds of developing a severe AE. Patients with baseline BMI greater than 24 kg/m2 (adjusted OR 2.72, 95%CI 1.25-5.89) were more likely to develop multiple AEs. CONCLUSION The incidence of ART-related adverse events over a 12-month period in China was high. Baseline BMI greater than 24 kg/m2, pre-existing multiple AEs, and pre-existing severe AEs were shown to be independent risk factors for developing a severe AE.
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Affiliation(s)
- Lili Dai
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - An Liu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Hongwei Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Ying Shao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Jianwei Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Jiangzhu Ye
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Shaoli Bai
- Department of Infectious Disease, Lanzhou Pulmonary Hospital, Lanzhou, 730046, China
| | - Xiaoling Guo
- Department of Infectious Disease, Lanzhou Pulmonary Hospital, Lanzhou, 730046, China
| | - Lijun Sun
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
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10
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Cardoso TS, Costa JDO, Reis EA, Silveira MR, Bonolo PDF, Santos SFD, Ceccato MDGB. Which antiretroviral regimen is associated with higher adherence in Brazil? A comparison of single, multi, and dolutegravir-based regimens. CAD SAUDE PUBLICA 2019; 35:e00115518. [PMID: 31531518 DOI: 10.1590/0102-311x00115518] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 04/05/2019] [Indexed: 11/22/2022] Open
Abstract
We evaluated adherence to highly active antiretroviral therapy (HAART) and its associated factors according to the type of regimen in patients initiating treatment in Belo Horizonte, Minas Gerais State, Brazil. We measured adherence using the eight items Morisky Therapeutic Adhesion Scale (MMAS-8) and compared the use of "backbone" tenofovir/lamivudine plus efavirenz one tablet once-daily (STR) or dolutegravir in multi-tablet once-daily (MTR-DTG), or other multi-tablet regimens (MTR-other). We conducted a multivariate logistic regression analysis to address factors associated with adherence. A total of 393 patients were included, 254 used STR, 106 MTR-DTG, and 33 MTR-other. The overall adhesion rate was 44.8% (95%CI: 39.4; 50.1), 50% for MTR-DTG, 43.3% for STR and 39.4% for MTR-other. Multivariate analysis showed a higher chance of adherence among patients using MTR-DTG, those who received and understood counseling about their treatment and with a higher quality of life. Prior use of illicit drugs in the lifetime was associated with poorer adherence. Overall adherence was low, highlighting the need for strategies focusing on counseling about medicines and substance use. Pill burden was not an issue for patients using MTR-DTG once-daily, who achieved better results.
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Almeida-Brasil CC, Nascimento ED, Silveira MR, Bonolo PDF, Ceccato MDGB. New patient-reported outcome measure to assess perceived barriers to antiretroviral therapy adherence: the PEDIA scale. CAD SAUDE PUBLICA 2019; 35:e00184218. [PMID: 31166419 DOI: 10.1590/0102-311x00184218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 12/27/2018] [Indexed: 11/21/2022] Open
Abstract
This study sought to develop and evaluate a new patient-reported outcome measure to assess perceived barriers to antiretroviral therapy (ART) adherence. The Perceived Barriers to Antiretroviral Therapy Adherence (PEDIA) scale was developed based on individual interviews with patients. After pilot testing and assessing the evidence based on content analysis, the scale's revisions resulted in a 40-item version. The PEDIA was applied to 415 HIV-infected adults receiving ART for a maximum of 180 days, recruited from three healthcare facilities of reference in the city of Belo Horizonte, Minas Gerais State, Brazil. The analyses included exploratory factor analysis, internal consistency, item response theory, temporal stability, and predictive test-criterion relationship. The scale's final version contains 18 items distributed in three dimensions, as follows: cognitive and routine problems (4 items); medication and health concerns (6 items); and patient's fears and feelings (8 items). The results of McDonald's omega and temporal stability demonstrate that the PEDIA is internally consistent and yields stable scores over time. The assessment of the information's functions suggested that the three dimensions were informative for assessing a broad range of latent traits. Evidence concerning the test-criterion relationship confirmed that the PEDIA was able to predict non-adherence three months later. Our findings suggest that the PEDIA is a psychometrically adequate tool for evaluating perceived barriers in adult patients initiating ART. It could be used in both research and clinical practice for the early detection of patients at risk of non-adherence and for the identification of potentially modifiable barriers.
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